How do I get rid of heavy upper lip? (Photo)

Hello, and thank you for sharing your concern along with photos.

Even if filler is no longer present, a “heavy” look above the upper lip can persist due to several factors:

Natural anatomy: Some individuals naturally have a thicker upper lip skin or more tissue volume in that area.

Aging changes: Over time, the upper lip tends to elongate and lose definition, which can make the area appear heavy.

Previous filler effects: Even after filler dissolves or is removed, subtle changes to the soft tissue and skin elasticity may remain.

Options to consider include:

Lip lift surgery: This shortens the distance between the upper lip and the nose, providing more definition and reducing heaviness.

Skin tightening or resurfacing treatments: Laser resurfacing, radiofrequency, or microneedling can help improve tissue laxity and skin texture above the lip.

Botox: While you’ve already been doing this for gummy smile, small adjustments in placement may also subtly improve lip balance.

Conservative filler placement elsewhere: Occasionally, adding filler strategically to surrounding areas (such as the chin or corners of the mouth) can create better harmony and reduce the perception of upper lip heaviness.

Since you’ve already had second opinions confirming no filler remains, your concern is likely structural or tissue-related rather than residual product. A combination of surgical and non-surgical approaches may be most effective in improving contour and balance.

Although HA soft tissue fillers are considered temporary, in some cases they can leave scar based lumps/irregularities in particular if they are placed in red portion of the lip. Direct excision may be the only modality that works. You should consult a board certified plastic surgeon in that regard.

You have a horizontal crease when you smile and you would benefit from a lip lift. A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners.

Best Wishes,

Gary Horndeski, M.D.